Paediatric Gastroenterology

What we do

We provide a comprehensive specialist inpatient and
outpatient service to both the local population and regionally to
the South West for the investigation and management of complex
gastrointestinal (GI), liver and nutritional conditions such as
Inflammatory Bowel Disease (IBD) ie. Crohn's disease, ulcerative
colitis, allergic gut conditions, coeliac disease, chronic
diarrhoea, failure to thrive, feeding problems, pancreatic and
liver disease, gut failure requiring intravenous feeding and
difficult cases of chronic abdominal pain including irritable bowel
disease (IBS).

A joint transition clinic with adult Gastroenterologists for
adolescents with GI conditions to adult services

Specialist visiting clinics from BRHC to Truro and
Swindon

Conditions we treat

We treat all GI conditions, and because there are so many, just
a few will be featured here.

Crohns Disease can cause inflammation in any of the areas of the
gut, from mouth to anus, but most commonly in the large and small
intestine. This inflammation may lead to ulceration, abscesses and
stricturing within the bowel. This is a chronic condition, with
periods of remission and relapse.

Ulcerative Colitis is inflammation of the
large bowel leading to ulceration and bleeding. It may effect the
whole of the large bowel or it may be only restricted to certain
areas. This is a chronic condition with periods of remission and
relapse.

Coeliac Disease is an auto-immune disease. In
patients with coeliac disease, antibodies; triggered by gluten,
wheat, rye and barley, cause an inflammatory response in the gut.
Specifically, the villi in the duodenum become inflamed and then
flattened. This results in a decreased surface area for the
absorption of nutrients.

Gastro-oesophageal reflux (GOR) this occurs when the acid or
partially digested food from the stomach flows back up the
oesophagus. Physiological reflux is common in infants (positing)
and gets better without investigation or treatment but excessive
GOR can rarely cause poor weight gain and/or pain because the
oesophagus is irritated.

Treatments offered

To investigate whether patients have any of these
conditions, they need to undergo an endoscopy. In
children this is usually done under a general anaesthetic and if a
lower endoscopy (colonoscopy) is needed, then bowel prep is
necessary. An endoscopy involves looking into the gut with a
flexible camera, biopsies are also taken.

Medication: A variety of medications are
utilised for the treatment of inflammatory bowel disease. These are
the most common drugs used by the gastro team:

Anti-inflammatory drugs are widely used such as
mesalazines

Prednisolone is a steroid used initially in high doses to
induce remission

A feed therapy is often indicated in the treatment of Crohns
disease. This is used to induce remission, is nutritionally
complete and excludes all other food for six weeks

Methotrexate, this is a folic antagonist and classified as a
cytotoxic drug. It is used as an immune suppressant

Azathioprine is an immune suppressant drug

Infliximab is an infusion that is given to also suppress the
immune system, it is an monoclonal antibody which inhibits the
pro-inflammatory cytokine, tumour necrosis factor